替加环素治疗成人急性白血病化疗后中性粒细胞缺乏伴发热疗效及对患者凝血功能、炎症因子的影响  

Curative effect of tigecycline in treatment of neutrophil deficiency with fever after chemotherapy in adult acute leukemia and its effect on coagulation function and inflammatory factors in patients

作　　者：孙慧宇 李梅君 SUN Huiyu;LI Meijun(The Third Affiliated Hospital of Jinzhou Medical University,Jinzhou 024000,China)

机构地区：[1]锦州医科大学附属第三医院,辽宁锦州024000

出　　处：《陕西医学杂志》2021年第11期1437-1440,共4页Shaanxi Medical Journal

摘　　要：目的:探讨替加环素对成人急性白血病化疗后中性粒细胞缺乏伴发热的疗效及对患者凝血功能与炎症因子的影响。方法:对79例急性白血病化疗后中性粒细胞缺乏并发热的成人患者进行研究,患者均为碳青霉烯类药物抗感染治疗无效者,继而使用替加环素治疗。记录替加环素治疗7 d的临床疗效、体温与中性粒细胞恢复时间、治疗前及治疗7 d时凝血功能指标[纤溶酶原激活抑制物-1(PAI-1)活性、D-二聚体(D-D)、血小板计数(PLT)、纤维蛋白原(FBG)、部分凝血酶原时间(APTT)、凝血酶原时间(PT)]、炎症因子水平[白细胞介素-6(IL-6)、C反应蛋白(CRP)],及治疗期间的相关不良反应情况。结果:临床疗效显效41例(51.90%),有效27例(34.18%),无效11例(13.92%),总有效率为86.08%(68/79);体温恢复时间(5.20±1.60)d,中性粒细胞恢复时间(6.20±1.48)d;治疗7 d时凝血功能指标FBG较治疗前更低(P<0.01),APTT与PT较治疗前更高(P<0.01),两组PAI-1、D-D与PLT对比差异无统计学意义(均P>0.05);治疗7 d时炎症因子指标(IL-6、CRP)较治疗前更低(均P<0.01),中性粒细胞数目较治疗前更高(P<0.01),体温较治疗前更低(P<0.01)。在治疗期间出现恶心呕吐3例、头痛2例,皮疹与肝肾功能异常各1例,不良反应发生率为8.86%(7/79)。结论:成人急性白血病化疗后中性粒细胞缺乏并发热患者使用替加环素治疗效果显著,可以有效抑制炎症反应,促使疾病康复,但该药对于凝血功能具有一定的影响,临床应加强凝血功能指标监测,以便保障治疗的安全性。Objective:To investigate the curative effect of tigecycline in the treatment of neutrophil deficiency with fever after chemotherapy in adult acute leukemia and its effect on coagulation function and inflammatory factors in patients.Methods:79 cases of acute leukemia patients with neutropenia and fever after chemotherapy were selected for the study.All patients were ineffective in anti infection treatment with carbapenems,and then treated with tigecycline.The clinical efficacy of tigecycline treatment for 7 days,body temperature and neutrophil recovery time after tigecycline treatment,coagulation function indexes[plasminogen activator inhibitor-1(PAI-1)activity,D-Dimer(D-D),platelet count(PLT),fibrinogen(FBG),partial prothrombin time(APTT),prothrombin time(PT)]and the levels of inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP)]before and after tigecycline treatment for 7 days,as well as the related adverse reactions during the treatment were recorded.Results:41 cases(51.90%)were markedly effective,27 cases(34.18%)were effective,11 cases(13.92%)were ineffective,and the total effective rate was 86.08%(68/79).The recovery time of body temperature was(5.20±1.60)d,neutrophil recovery time was(6.20±1.48)d.After 7 days of treatment,FBG was lower than that before treatment(P<0.01),APTT and PT were higher than those before treatment(all P<0.01),and there was no significant difference in PAI-1,D-D and PLT between the two groups(all P>0.05);the levels of inflammatory factors(IL-6,CRP)were lower than those before treatment(all P<0.01),the number of neutrophils was higher than that before treatment(P<0.01),and the body temperature was lower than that before treatment(P<0.01).During the treatment,there were 3 cases of nausea and vomiting,2 cases of headache,1 case of rash and 1 case of liver and kidney dysfunction,and the incidence of adverse reactions was 8.86%(7/79).Conclusion:Tigecycline is effective in the treatment of acute leukemia patients with neutropenia and fever after chemotherapy,which can effective

关 键 词：替加环素 急性白血病 化疗 中性粒细胞缺乏 发热 凝血功能 

分 类 号：R733.71[医药卫生—肿瘤]